Pharmacology

Question 1

Flourescein

Answer 1

Orange dye that when used with a woods lamp, corneal abrasions, foreign bodies, ulcers, infection and herpatic dendrites can be seen.

Question 2

Topical anesthetic MOA

Answer 2

Stabilizes neuronal membranes inhibiting nerve impulses.

Question 3

Short-acting topical anesthetics

Answer 3

Proparacaine (Alcaine)
Oxybrupocaine/Benoxinate (novesin, novesine)
Very short acting
-Benoxinate comes in combo with flourescine
-Proparicaine is most often used because there is less stinging on application.

Question 4

Tetricaine (pontocaine)

Answer 4

Longer acting topical anesthetic

Question 5

Topical Anesthetic SE

Answer 5

• Stinging, irritation
• Hypersensitivity rxn
• Prolonged use may inhibit healing
• Must protect eye from irritants until it wears off.

Question 6

Topical Anesthetic CI

Answer 6

• *Never write a script for these!**
• Any hypersensitivity to anesthetics
• liver disease
• Anticholinesterases
• Dry eye
• Perforating eye injury

Question 7

Diclofenac (Voltaren)

Answer 7

NSAID used for post-op pain/inflammation after cataract surgery

Question 8

Ketorlac (acular)

Answer 8

NSAID: Can be used for allergic conjunctivitis.

Question 9

Dont use opth. NSAIDS for longer than _______ weeks

Answer 9

two. can cause corneal injury

Question 10

Corticosteroids

Answer 10

Use of corticosteroids should be reserved for an opthalmologist

Question 11

Corticosteroid indications

Answer 11

• Acute iritis
• Stromal keratitis
• Chemical burns
• (Epi)scleritis

Question 12

Prednisolone acetate 1% soln (Pred Forte)

Answer 12

• Most commonly used opthalmic corticosteroid

- Dexamethasone and Flourometholone are also used.

Question 13

Corticosteroid SE

Answer 13

Short-term: Mydriasis, Ptosis, healing inhibition.

Long-term: Cataracts, corneal thinning/rupture, glaucoma, immmunosuppression, keratitis.

Question 14

Corticosteroid CI

Answer 14

Viral or fungal disease of cornea or conjunctiva

Question 15

Decongestants MOA

Answer 15

Over the counter

Causes pupil dilation, increase outflow of aqueous humor, vasoconstriction.

Question 16

Decongestant Indications

Answer 16

Allergic conjunctivitis (redness, itching, burning, excessive tearing)

Question 17

Decongestant SE

Answer 17

Burning, blurred vision, pupil dilation, rebound congestion.

Not to be used with glaucoma

Question 18

Antihistamines

Answer 18

Prescription and OTC
Patanol (prescription)
Ketotifen (OTC)

Question 19

Antihistamine SE

Answer 19

Eye irritation, stinging upon application.

Question 20

Most antihistamines can be used with ______ ______ _____.

Answer 20

Contact lens wearers. Must take out for 10 minutes before and after application.

Question 21

Mast Cell Stabilizer

Answer 21

Cromolyn Sodium (Opticrom)
Inhibits mast cell degranulation
Must take 4x per day
Can use long-term

Question 22

Sulfonamide MOA

Answer 22

ABx: Inhibits synthesis of folic acid

Question 23

Sulfonamide Indication

Answer 23

Lid infxns
Conjunctivitis
Corneal abrasion, ulcer
Infxn prevention

Question 24

Sulfacetamide

Answer 24

Bleph-10, Ocu-Sul, Sodium Sulamyd, Sulf-10

Question 25

Sulfonamide SE

Answer 25

Local irritation, stinging, burning

Question 26

Flouroquinolones MOA

Answer 26

ABx: Inhibits DNA synthesis

Question 27

Flouroquinolones Indications

Answer 27

``` Lid infxns Conjunctivitis (not 1st line) Corneal abrasion, ulcer Prevent infxns *Should be used in pseudomonas is suspected.* **contact lens wearers = pseudomonas** ```

Question 28

Flouroquinolone types

Answer 28

Ciproflaxacin, Ofloxacin, Levofloxacin, Moxifloxacin

Question 29

Flouroquinolones SE

Answer 29

Burning, stinging, foreign body sensation, photophobia

Question 30

Aminoglycosides MOA

Answer 30

Bind to ribosomes and inhibit tRNA synthesis

Question 31

Aminoglycosides indications

Answer 31

Lid infxns Conjunctivitis Corneal abrasion, ulcer Infxn prevention

Question 32

Aminoglycosides types

Answer 32

Gentamycin, Tobramycin, | Neomycin (high incidence of allergy)

Question 33

Aminoglycosides SE

Answer 33

**Generally avoid these for run of the mill conjunctivitis** | Burning, itching, erythema

Question 34

Macrolides MOA

Answer 34

Inhibits tRNA synthesis

Question 35

Macrolide Types

Answer 35

Erythromycin (cheap), Azythromycin (spendy)

Question 36

Macrolide Indications

Answer 36

Same as the others

Question 37

Bacitracin MOA

Answer 37

Inhibits bacterial cell wall synthesis

Question 38

Bacitracin Indications

Answer 38

Lid infxns Conjunctivitis Corneal abrasion, ulcer Prevent infxns

Question 39

Trimethoptrim Sulfate (Polytrim)

Answer 39

Combo of two antibiotics Ok for sulfa allergies!! Used for the same stuff.

Question 40

Idoxuridine (Dendrid)

Answer 40

- Antiviral - Used for herpes simplex keratitis - Blocks reproduction of HSV

Question 41

Trifuridine (Viroptic)

Answer 41

- Antiviral - Used for keratoconjunctivitis, keratitis - May cause burning, stinging Used if vidarabine is ineffective

Question 42

Vidarabine (Vira-a)

Answer 42

- Used for keratoconjunctivitis and keratitis | - May cause haze, burning

Question 43

You should never treat ocular herpes in a _____ _____ setting.

Answer 43

Primary care. refer to optho.

Question 44

Cycloplegics MOA

Answer 44

Paralyze the ciliary muscles and cause dilation of the pupil.

Question 45

Cycloplegic Indications

Answer 45

- Dilation before eye exam - Pre and post-op - Pain relief for abrasions/iritis/uveitis

Question 46

Cycloplegic types

Answer 46

Atropine, Scopolamine, Cyclopentolate, Mydriacyl

Question 47

Cycloplegic CI

Answer 47

- Angle closure glaucoma - People w/ narrow angles - Caution in children and elderly

Question 48

Cycloplegic SE

Answer 48

``` Blurred vision Burning/stinging Eye irritation Photophobia Swelling of eyelids ```

Question 49

Agents for glaucoma

Answer 49

1st line: Prostaglandin Analogs | 2nd line: Beta Blockers

Question 50

Prostaglandin Analog MOA

Answer 50

Increase uveoscleral flow

Question 51

Prostaglandin types

Answer 51

Latanoprost (Xalatan) Bimatoprost (Lumigan) Tafloprost (Zioptan)

Question 52

Prostaglandin SE

Answer 52

Decreased visual acuity Eye discomfort Dry eye Foreign body sensation

Question 53

Prostaglandin may decrease efficacy of ________.

Answer 53

NSAIDS

Question 54

Beta Blocker MOA

Answer 54

May decrease aqueous humor formation or increase outflow.

Question 55

Beta Blocker types

Answer 55

``` Betaxolol (Betoptic) - selective Timolol maleate (Timoptic) - non Levobunolol (Betagan) - non ```

Question 56

Beta Blocker SE

Answer 56

``` Decrease Cardiac output Bronchospasm Bradycardia Heart block Hypotension ```

Question 57

Beta Blocker CI

Answer 57

``` Asthma COPD Sinus bradycardia 2nd or 3rd degree AV block Overt cardiac failure ```

Question 58

Alpha Andrenergic Agonists MOA

Answer 58

- Reduces intraocular pressure (IOP) by increasing outflow and reducing aqueous humor production - 3rd line for glaucoma - effective but not commonly used due to SE, many drug interactions

Question 59

Alpha Andrenergic Agonist Types

Answer 59

Brimonidine (Alphagan P) | Apraclonidine (Iopidine)

Question 60

Cholinergic Agonists MOA

Answer 60

Contract ciliary muscle, allowing increased outflow. | **out of favor**

Question 61

Cholinergic Agonists SE

Answer 61

Brow ache, Induced Myopia, Decreased vision in low light. | **Out of favor**

Question 62

Carbonic anhydrase inhibitirs

Answer 62

Acetazolamide. Do not appear to be as effective as other therapies, but can be used when treatment of angle closure glaucoma is delayed

Question 63

T or F: Eye drops do not have systemic effects

Answer 63

False. They do. Look that shit up.